UNASSIGNED: Limited data reporting real-world prevalence of integrase strand transfer inhibitor resistance (INSTI-R) in the USA are available because their recommendation as first-line treatment in 2017. Reported national surveillance data in the USA estimated INSTI-R to be 6.3% as of 2018. This article aims to describe estimated prevalence of INSTI-R within a single clinic network in Chicago, IL, USA, and identify risk factors for resistance and virological failure (VF).
UNASSIGNED: This was a retrospective, single-centre study of adults with HIV starting an INSTI-containing regimen between September 2017 and 2020. The primary endpoint was the difference in INSTI-R of the sample population compared with the national prevalence. Other outcomes included VF and documented INSTI-R mutations.
UNASSIGNED: Of 948 participants screened, 321 were included. Eight people had baseline INSTI-R testing results available, of which five had INSTI-R at baseline for an estimated prevalence of 1.6%. This estimation was significantly less than the national estimated prevalence of 6.3% (p<0.001). VF occurred in 26 (7.8%) individuals. Because no participants acquired INSTI-R during the study period, investigators were unable to identify risk factors associated with the development of INSTI-R. People with high pre-treatment viral loads had 1.21 (95% CI 1.05-1.39) higher odds of VF.
UNASSIGNED: Amongst participants on INSTI-containing regimens, INSTI-R rates were estimated to be lower than the estimated national prevalence. Detectable pre-switch viral loads were more associated with VF than undetectable viral loads.

OBJECTIVE: A meeting of a Canadian group with significant experience and knowledge in HIV management, consisting of five physicians, a pharmacist and an AIDS researcher, was convened. Their goal was to develop guidance for Canadian HIV-treating physicians on the appropriate use of raltegravir (MK-0518, Isentress(R), Merck Frosst Canada Inc) in HIV-infected adults.
METHODS: Evidence from the published literature and conference presentations, as well as expert opinions of the group members, was considered and evaluated to develop the recommendations. Feedback on the draft recommendations was obtained from this core group, as well as from five other physicians and scientists across Canada with expertise in HIV treatment and antiretroviral drug resistance, and experience in the use of raltegravir. The final recommendations represent the core group\'s consensus agreement once all feedback was considered.
CONCLUSIONS: Recommendations were developed to guide physicians in the optimal use of raltegravir. The issues considered included raltegravir\'s role in overall treatment strategy, efficacy, durability of effect, rate of viral load reduction, resistance, safety/toxicity, pharmacokinetics and drug interactions.

Interpreting the results of drug resistance tests for HIV-1 is one of the most difficult tasks for both clinicians and virologists. There are many amino acid changes in viral proteins influencing the susceptibility to specific drugs, causing loss of activity or conversely hypersusceptibility. Moreover, the results of interactions derived from complex mutational patterns are difficult to predict. Different interpretation algorithms have been developed to facilitate the translation of information obtained in the genotypes to clinicians. Controversy exists, however, regarding the impact of genotypic changes over the activity of many antiretroviral drugs. Based on virologic outcomes, scientific literature, and expert opinion, the Drug Resistance Platform of the Spanish AIDS Research Network (RIS, Red de Investigación en SIDA) has developed over the last years its own interpretation system. Herein, we present the 2009 guidelines, in which special efforts have been made to standardize the criteria for interpreting resistance mutations for compounds within the same drug family and to facilitate the clinical interpretation of HIV-1 resistance genotypes.

暂无摘要。